MEDICARE: LONE STAR MEDPED PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1386046936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR MEDPED PLLC

Provider Business Mailing Address
First Line	:	6033 AIRLINE DR STE C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-4243
Country	:	US
Telephone Number	:	713-694-2808
Fax Number	:	713-694-2833

Provider Business Practice Location Address
First Line	:	6033 AIRLINE DR
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77076-4209
Country	:	US
Telephone Number	:	713-694-2808
Fax Number	:	713-694-2833

Authorized Official
Title or Position	:	OWNER
Name	:	PRAYMAL THAKRAR
Credential	:	M.D
Telephone Number	:	713-694-2808

Provider Enumeration Date	:	09/25/2014
Last Update Date	:	12/02/2025

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Directions to “LONE STAR MEDPED PLLC ” Practice Location

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